The field of telehealth is advancing rapidly and hearing instruments which can be adjusted remotely have recently been developed. Techniques for fitting and evaluating hearing aids in the home will be developed using a computer-based system linked to the internet. The system will include a method for self-administered auditory training with progress monitored remotely over the internet. Remote adaptive adjustment of the hearing-aid's electroacoustic characteristics will be used to maximize speech-recognition skills with the hearing aid. These adjustments will be made on an ongoing basis as the user adapts to acoustic amplification. The intended application of the system is for older people with hearing loss who are home-bound or who have difficulty reaching a hearing-aid dispensary because of distance or other constraints on travel. PUBLIC HEALTH RELEVANCE: A method for fitting and evaluating a hearing aid in a person's home instead of a clinic will be developed and evaluated. The method will be of benefit to people who live in remote areas or who may live in the vicinity of a hearing clinic but have great difficulty in traveling to a clinic. The method of fitting will take into account the type of background noise commonly encountered in the home. A hearing aid that can be programmed remotely by a computer will be used. The computer will also be used to implement novel ways of assessing how well the hearing aid is working using an adaptation of an evaluation method using conversational speech known as speech tracking. The technique will also be used for auditory training in the home. The system will be evaluated in an experiment designed to determine the effects of auditory training on speech recognition as well as the effect of adaptation to acoustic amplification.